1. Form a General Impression
When determining the severity of an equestrian injury, you probably already have a gut feeling about what you just witnessed. Sometimes perception is reality and sometimes looks are deceiving though, so forming a general impression is important. You will first look to see the position of the victim and notice immediately whether an injury is suspect (such as a femur protruding from the pants and through the skin, or an arm facing the wrong way). You should also take this time to listen for moaning, snoring or gurgling respirations. This indicates a very severe injury. You also want to take note of any smells such as urine, feces or vomit. These too indicate the presence of life threatening trauma.
2. Assess Mental Status
One other way to determine that this injury is really bad is if the victim is conscious or knocked out. You determine this by her responsiveness to stimuli. A good acronym to use is AVPU (Alert, Verbal, Painful, Unresponsive). Alert is that she is sitting up talking, verbal is unconscious but responds when spoken to, painful is responsive only when given a painful stimuli such as a pinch or sternal rub and unresponsive is no response and is not good at all.
3. Check your ABCs
The next important step is to check for a viable airway: if the victim is breathing and if the victim has a pulse. At this time, you will also check for any kind of severe bleeding and attempt to control it. You will also want to check for crepitus at this point. This is a gruesome task, but it is a necessary one. You gently massage areas of the body such as the skull, arms, legs and chest--feel if you are rubbing bone against bone. This indicates that you have a break or a fracture.
4. Get Vital Signs
Regardless if the victim is alert or unconscious, you should always check the vital signs. They can tell you if there is something going on even when the victim thinks she is fine. You will check the pulse rate, respiration rate, skin color, skin temperature, pupil constriction and blood pressure. Blood pressure may be difficult to get unless you carry around a cuff, but the others are easily obtainable and they will tell you whether or not you need professional help and how soon.
5. Check for Distal PMS
Another important step to take is to check for pulse on the feet and wrist, whether or not they can feel you touching their hands and feet and whether or not they can push back or pull up your hands with their feet and hands. This will indicate whether or not there has been spinal injury.
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